University of Oxford RECOVERY Trial Leads to Evidence Dexamethasone Reduces COVID-19 Deaths

Jun 16, 2020 | COVID-19, Dexamethasone, News, Positive Results, RECOVERY Trial, University of Oxford

University of Oxford RECOVERY Trial Leads to Evidence Dexamethasone Reduces COVID-19 Deaths

The RECOVERY trial led by Peter Horby of University of Oxford in England reveals the first evidence that a drug can improve COVID-19 survival; a cheap and widely available steroid called dexamethasone reduced deaths by up to one third in severely ill hospitalized patients. With results just announced, the study team is working on the publication.

The University of Oxford ramped up the RECOVERY trial at the end of March as a pragmatic effort to assess the effects of experimental drug treatments for patients hospitalized due to SARS-CoV-2. The study was designed to test a range of therapeutic targets, including dexamethasone.

The Treatment

According to the Mayo Clinic, Dexamethasone provides relief for inflamed areas of the body. It is used to treat a number of different conditions, such as inflammation (swelling), severe allergies, adrenal problems, arthritis, asthma, blood or bone marrow problems, kidney problems, skin conditions, and flare-ups of multiple sclerosis. Dexamethasone is a corticosteroid (cortisone-like medicine or steroid). It works on the immune system to help relieve swelling, redness, itching, and allergic reactions.

The Study

Called the RECOVERY study, a total of 2104 patients were randomized to receive dexamethasone 6 mg once per day (either by mouth or by intravenous injection) for ten days and were compared with 4321 patients randomized to usual care alone. Among the patients who received usual care alone, 28-day mortality was highest in those who required ventilation (41%), intermediate in those patients who required oxygen only (25%), and lowest among those who did not require any respiratory intervention (13%).

Dexamethasone reduced deaths by one-third in ventilated patients (rate ratio 0.65 [95% confidence interval 0.48 to 0.88]; p=0.0003) and by one fifth in other patients receiving oxygen only (0.80 [0.67 to 0.96]; p=0.0021). There was no benefit among those patients who did not require respiratory support (1.22 [0.86 to 1.75; p=0.14).  Based on these results, 1 death would be prevented by treatment of around 8 ventilated patients or around 25 patients requiring oxygen alone.

Given the public health importance of these results, the researchers are now working to publish the full details as soon as possible.

Peter Horby, Professor of Emerging Infectious Diseases in the Nuffield Department of Medicine, University of Oxford, and one of the Chief Investigators for the trial, said, “Dexamethasone is the first drug to be shown to improve survival in COVID-19. This is an extremely welcome result. The survival benefit is clear and large in those patients who are sick enough to require oxygen treatment, so dexamethasone should now become standard of care in these patients. Dexamethasone is inexpensive, on the shelf, and can be used immediately to save lives worldwide.”

Martin Landray, Professor of Medicine and Epidemiology at the Nuffield Department of Population Health, University of Oxford, one of the Chief Investigators, said, “Since the appearance of COVID-19 six months ago, the search has been on for treatments that can improve survival, particularly in the sickest patients. These preliminary results from the RECOVERY trial are very clear – dexamethasone reduces the risk of death among patients with severe respiratory complications. COVID-19 is a global disease – it is fantastic that the first treatment demonstrated to reduce mortality is one that is instantly available and affordable worldwide.”

The UK Government’s Chief Scientific Adviser, Sir Patrick Vallance, said“This is tremendous news today from the Recovery trial showing that dexamethasone is the first drug to reduce mortality from COVID-19. It is particularly exciting as this is an inexpensive widely available medicine. This is a ground-breaking development in our fight against the disease, and the speed at which researchers have progressed finding an effective treatment is truly remarkable. It shows the importance of doing high quality clinical trials and basing decisions on the results of those trials.”

Collaborators

·         University of Oxford

·         UK Research and Innovation

·         National Institute for Health Research, United Kingdom

·         Wellcome

·         Bill and Melinda Gates Foundation

·         Department for International Development, United Kingdom

·         Health Data Research UK

·         Medical Research Council Population Health Research Unit

·         NIHR Clinical Trials Unit Support Funding

Lead Research/Investigator

Peter W. Horby, Oxford University

Call to Action: These results have significant implications. TrialSite News will monitor additional dexamethasone studies.

0 Comments

Pin It on Pinterest